A Median Neuropathy Caused by Brachial Pseudoaneurysm after Angiography: a Case Report

J Korean Assoc EMG Electrodiagn Med 2004;6(1):79-82.
Published online May 10, 2004.

Abstract

The incidence of pseudoaneurysm after angiography ranges from 0.05 to 0.5 percent. We report a case of a median neuropathy caused by brachial pseudoaneurysm after angiography. A 70-year old man visited hospital due to right 5th toe gangrene and was diagnosed as atherosclerosis obliterans of bilateral iliac artery. Before bypass graft surgery, he was performed angiography using left brachial artery approach. Two days after angiography, weakness and dysethesia of left hand developed. Electrodiagnositc studies revealed severe median neuropathy above elbow level. In doppler sono study, a 4-cm diameter of brachial pseudoaneurysm just above the antecubital fossa was detected. Surgical resection of the pseudoaneurysm was performed on 15th days after angiography. Four months after surgical resection, electrodiagnositc study showed early regeneration signs in left abductor pollicis brevis muscle. Thorough clinical evaluation and early diagnosis of pseudoaneurysm is essential for preventing secondary compressive nerve injury and favorable clinical outcome.

Key Words: Brachial artery, Pseudoaneurysm, Median neuropathy, Angiography